Global Governance Reform: An American View of U.S. Leadership

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President Barack Obama has trumpeted a "new era of engagement" for the United States. The central components of his strategy include a world order characterized by peaceful accommodation between established and rising powers; the collective management of transnational problems; and the overhaul of international institutions to reflect these shifting power dynamics and the new global agenda. Placing less emphasis than his predecessor on the pursuit of American primacy, Obama envisions-indeed, insists-that other global powers assume new responsibilities.

Notwithstanding its multilateral instincts, though, the Obama administration is limited in its practical ability to promote and embrace sweeping reforms to global governance. Therefore, rather than casting its lot entirely with universal organizations like the United Nations, the United States will adopt a pragmatic approach to international cooperation that combines formal institutions with more flexible partnerships to achieve US national interests.

The balance sheet for Obama's first year in office underscores both the opportunities for, and the constraints on, global governance reform in the current geopolitical environment.

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Rates of heart disease, cancer, diabetes, and other noncommunicable diseases (NCDs) in low- and middle-income countries are increasing faster than in wealthier countries. The report outlines a plan for collective action on this growing epidemic.